Ryan Chandler Upright, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Spencer, NC

NPI 1669958807 · NPPES record last updated Jul 11, 2018

Key facts

NPI
1669958807
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
11884 (NC)
Practice address
1404 S Salisbury Ave
Spencer, NC 28159-1921
Phone
(704) 633-3892
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11884NCMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 11884 NC Yes

Addresses

Primary practice location

1404 S Salisbury Ave
Spencer, NC 28159-1921

Mailing address

PO Box 1243
Kannapolis, NC 28082-1243
Phone (704) 796-0155

Other providers in Spencer, NC

All providers in Spencer, NC · Occupational Therapy Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.